Why should I have my wisdom teeth removed?

If you do not have enough room in your mouth for your third molars to fully erupt, several problems can happen. Impacted wisdom teeth should be removed before their root structure is fully developed. In some patients, it is as early as 12 or 13, and in others it may not be until the early twenties. Problems tend to occur with increasing frequency after the age of 30. Some of the possible problems related to not removing your wisdom teeth include:

A representation of a pericoronitis infection on a wisdom tooth

Infection:

The most frequent clinical problem we see is pericoronitis (a localized gum infection). Without enough room for total eruption, the gum tissue around the wisdom tooth is difficult to clean and can become irritated and infected, resulting in recurrent pain, swelling, and problems with chewing and/or swallowing.

An example of a cyst formation on a wisdom tooth

Cyst Formation:

Rarely, non-infectious diseases may also arise in association with an impacted wisdom tooth. Cysts are fluid-filled “balloons” inside the jaw bone that develop as a result of impacted teeth and slowly expand destroying adjacent jaw bone and occasionally teeth. They can be very difficult to treat if your wisdom teeth are not removed in your teenage years. Although rare, tumors can be associated with the delayed removal of wisdom teeth.

An illustration of teeth crowding causes by a wisdom tooth

Possible Crowding:

Impacted wisdom teeth may contribute to crowding of your teeth. This is most noticeable with the front teeth, primarily the lower front teeth. There are a number of factors that cause teeth to crowd after braces or in early adulthood. Retained, impacted wisdom teeth may be a contributing factor.  Sometimes wisdom teeth will be extracted to reduce the risk of crowding.

A visual of a wisdom tooth damaging an adjacent tooth

Cavities and Periodontal Disease:

If there is inadequate room to clean around the wisdom tooth, the tooth directly in front, the second molar, can be adversely affected resulting in cavities, bone loss around the tooth and periodontal disease.  Sometimes the bone loss can be significant resulting in a loose second molar tooth.  If a cavity in the second molar tooth is too deep, the dentist may not be able to fill the tooth and instead it may need to be extracted.  If a cavity develops in the second molar or wisdom tooth, pain may also occur.

What If I Don’t Have My Wisdom Teeth Removed As A Teenager Or Young Adult?

As wisdom teeth develop, the roots become longer and the jaw bone becomes more dense. When it is necessary to remove impacted wisdom teeth in your thirties, forties or beyond, the post-operative healing can be prolonged (more pain and swelling).  In general, you will heal faster, more predictably and have fewer complications if treated in your teens or early twenties.